| NPI | 1922098573 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX N3080) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 058193) |
| Enumeration Date | 2005-10-25 |
| Last Update Date | 2020-09-18 |