| NPI | 1366070864 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX V0582) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 5101027256) |
| 207P00000X Emergency Medicine (Licence: MI 5151014331) | |
| Enumeration Date | 2020-03-30 |
| Last Update Date | 2024-06-27 |