| NPI | 1477842268 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WA MD60445790) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX R0691) |
| 207P00000X Emergency Medicine (Licence: IN 01071391A) | |
| Enumeration Date | 2011-03-31 |
| Last Update Date | 2019-10-23 |