| NPI | 1659326650 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX P1452) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AL 25650) |
| 207P00000X Emergency Medicine (Licence: PA MD027124E) | |
| Enumeration Date | 2006-05-24 |
| Last Update Date | 2016-12-19 |