| NPI | 1962723288 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX P8707) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 5101018890) |
| Enumeration Date | 2010-06-21 |
| Last Update Date | 2024-09-19 |