| NPI | 1669636775 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL OS15975) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX N2049) |
| Enumeration Date | 2008-07-17 |
| Last Update Date | 2023-01-19 |