| NPI | 1124522883 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX S4683) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IA MD-48332) |
| Enumeration Date | 2018-03-19 |
| Last Update Date | 2022-09-30 |