| NPI | 1679756084 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX Q3535) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MS T2036) |
| Enumeration Date | 2007-12-07 |
| Last Update Date | 2018-08-28 |