| NPI | 1609813872 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX M9986) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME92370) |
| Enumeration Date | 2006-05-31 |
| Last Update Date | 2020-09-22 |