| NPI | 1538149083 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: ID M11217) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME79530) |
| 207P00000X Emergency Medicine (Licence: TN 45301) | |
| 207P00000X Emergency Medicine (Licence: TX N9375) | |
| Enumeration Date | 2006-01-19 |
| Last Update Date | 2022-07-21 |