| NPI | 1184207938 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX BP10075309) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX U1111) |
| Enumeration Date | 2021-04-29 |
| Last Update Date | 2023-03-14 |