| NPI | 1871786640 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX Q4625) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MT188131) |
| Enumeration Date | 2007-08-24 |
| Last Update Date | 2022-12-13 |