| NPI | 1740235076 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MD H67639) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX L7508) |
| 207P00000X Emergency Medicine (Licence: VA 0102202305) | |
| Enumeration Date | 2006-05-24 |
| Last Update Date | 2020-01-05 |