| NPI | 1033552831 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX R1325) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OK 6923) |
| Enumeration Date | 2013-04-10 |
| Last Update Date | 2020-06-23 |