| NPI | 1053873174 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: UT 13593237-1205) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX T2052) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-04-05 |
| Last Update Date | 2024-03-21 |