| NPI | 1588041990 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NM MD2019-0641) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: UT 10092294-1205) |
| Enumeration Date | 2015-05-05 |
| Last Update Date | 2019-08-23 |