| NPI | 1982866935 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX R4528) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 67268) |
| 207P00000X Emergency Medicine (Licence: CT 64851) | |
| 207P00000X Emergency Medicine (Licence: AR E-6786) | |
| Enumeration Date | 2008-07-01 |
| Last Update Date | 2024-06-24 |