| NPI | 1508002312 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX P7445) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA OS014638) |
| Enumeration Date | 2008-12-29 |
| Last Update Date | 2022-05-13 |