| NPI | 1821230384 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WY 10491A) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX P2673) |
| 207P00000X Emergency Medicine (Licence: IL 036129250) | |
| Enumeration Date | 2009-03-30 |
| Last Update Date | 2020-10-05 |