| NPI | 1407803760 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX M3457) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KS 04-27935) |
| Enumeration Date | 2006-05-30 |
| Last Update Date | 2022-07-21 |