| NPI | 1114508934 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NE 36418) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX V1118) |
| Enumeration Date | 2021-04-15 |
| Last Update Date | 2024-09-14 |