| NPI | 1013446863 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX S5126) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX BP10061464) |
| Enumeration Date | 2017-06-06 |
| Last Update Date | 2020-07-31 |