| NPI | 1902429632 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX U2817) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 5151014233) |
| Enumeration Date | 2020-05-28 |
| Last Update Date | 2024-06-22 |