| NPI | 1154859148 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX S8009) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OK 6374) |
| Enumeration Date | 2017-06-02 |
| Last Update Date | 2024-10-08 |