| NPI | 1861673014 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A113760) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX BT23410665231) |
| Enumeration Date | 2007-11-15 |
| Last Update Date | 2021-12-14 |