| NPI | 1891145983 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MN 70195) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX BP10056876) |
| Enumeration Date | 2016-06-20 |
| Last Update Date | 2023-09-12 |