| NPI | 1619322369 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX s6960) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CT 62536) |
| Enumeration Date | 2016-05-02 |
| Last Update Date | 2020-07-14 |