| NPI | 1023269172 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX N8874) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: UT 7150810-1205) |
| Enumeration Date | 2008-10-07 |
| Last Update Date | 2023-09-27 |