| NPI | 1508214768 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A166146) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX S0798) |
| Enumeration Date | 2016-05-28 |
| Last Update Date | 2025-01-09 |