| NPI | 1467637462 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX N6534) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 002726) |
| Enumeration Date | 2008-01-08 |
| Last Update Date | 2021-03-03 |