| NPI | 1114975943 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX P0032) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MO 2004036764) |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2022-04-20 |