| NPI | 1083673016 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX P4138) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME82194) |
| Enumeration Date | 2006-03-20 |
| Last Update Date | 2021-03-01 |