| NPI | 1912317736 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX Q7390) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NV 17920) |
| 207P00000X Emergency Medicine (Licence: CA A149010) | |
| Enumeration Date | 2014-05-01 |
| Last Update Date | 2020-02-19 |