| NPI | 1457675472 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX Q9214) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: LA MD.205274) |
| 207P00000X Emergency Medicine (Licence: VA 0101255577) | |
| Enumeration Date | 2010-03-19 |
| Last Update Date | 2019-06-25 |