| NPI | 1144843970 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OK 8009) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX T2568) |
| 207Q00000X Family Medicine (Licence: TX T2568) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX BP10071685) | |
| Enumeration Date | 2020-05-27 |
| Last Update Date | 2024-11-07 |