| NPI | 1477672483 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OR MD176548) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MO 2006017109) |
| 207P00000X Emergency Medicine (Licence: MO 2008029062) | |
| 207P00000X Emergency Medicine (Licence: TX q2428) | |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2016-09-29 |