| NPI | 1700819232 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME125977) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX M3268) |
| Enumeration Date | 2006-07-08 |
| Last Update Date | 2020-08-27 |