| NPI | 1518491067 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX S0187) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301503432) |
| Enumeration Date | 2017-04-11 |
| Last Update Date | 2024-05-08 |