| NPI | 1548233968 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX M2572) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: LA 25833) |
| Enumeration Date | 2006-02-08 |
| Last Update Date | 2022-08-17 |