| NPI | 1003059783 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX R0663) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TN 47995) |
| 207P00000X Emergency Medicine (Licence: LA MD.206331) | |
| Enumeration Date | 2009-04-10 |
| Last Update Date | 2020-08-20 |