| NPI | 1457581589 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX P7210) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: LA 207780) |
| 207P00000X Emergency Medicine (Licence: MI 4301094565) | |
| Enumeration Date | 2009-07-23 |
| Last Update Date | 2018-04-24 |