| NPI | 1013413046 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: LA 320434) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX S6808) |
| Enumeration Date | 2018-03-30 |
| Last Update Date | 2022-03-03 |