| NPI | 1184041402 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AZ 68097) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX R6185) |
| Enumeration Date | 2014-03-25 |
| Last Update Date | 2024-12-04 |