| NPI | 1063522829 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX Q0368) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME100702) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2022-11-01 |