| NPI | 1710957832 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX N7855) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 68928) |
| 207P00000X Emergency Medicine (Licence: SC 000653) | |
| 207P00000X Emergency Medicine (Licence: TN 2070) | |
| 207P00000X Emergency Medicine (Licence: KY C2999) | |
| Enumeration Date | 2006-01-23 |
| Last Update Date | 2025-02-03 |