| NPI | 1043664873 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX S5042) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TN MD0000056658) |
| Enumeration Date | 2016-04-18 |
| Last Update Date | 2020-06-29 |