| NPI | 1447870464 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WI 81915) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 5151015174) |
| 207P00000X Emergency Medicine (Licence: TX V1156) | |
| Enumeration Date | 2020-04-20 |
| Last Update Date | 2025-06-18 |