| NPI | 1548503311 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME125638) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX Q7882) |
| Enumeration Date | 2013-03-30 |
| Last Update Date | 2022-11-01 |