| NPI | 1922010867 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA G69852) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX T4513) |
| 207P00000X Emergency Medicine (Licence: FL ME153176) | |
| Enumeration Date | 2006-08-12 |
| Last Update Date | 2021-12-16 |