| NPI | 1568776565 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AR E-14570) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX P3654) |
| 207P00000X Emergency Medicine (Licence: OK 38048) | |
| 207P00000X Emergency Medicine (Licence: DE C1-0025069) | |
| Enumeration Date | 2010-08-02 |
| Last Update Date | 2023-06-23 |