| NPI | 1023429370 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MA 290969) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX R3167) |
| Enumeration Date | 2014-05-08 |
| Last Update Date | 2022-10-05 |