| NPI | 1417169962 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX p3597) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NV 12938) |
| Enumeration Date | 2007-05-05 |
| Last Update Date | 2022-11-01 |