| NPI | 1669671657 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX R8460) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301088467) |
| Enumeration Date | 2007-07-11 |
| Last Update Date | 2022-08-19 |