| NPI | 1629381538 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX P9101) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 5101018667) |
| Enumeration Date | 2010-07-20 |
| Last Update Date | 2024-09-19 |