| NPI | 1669406393 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SC 36256) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 241155) |
| 207P00000X Emergency Medicine (Licence: TX M6620) | |
| 207P00000X Emergency Medicine (Licence: NC 2004-00031) | |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2023-07-17 |