| NPI | 1861837569 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX R9107) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI L2434744) |
| Enumeration Date | 2013-05-08 |
| Last Update Date | 2024-07-18 |