| NPI | 1811998453 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX L4943) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AR E-10044) |
| 207P00000X Emergency Medicine (Licence: CA G77222) | |
| Enumeration Date | 2005-08-04 |
| Last Update Date | 2023-04-17 |