| NPI | 1205360476 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX S0285) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 85529) |
| Enumeration Date | 2017-04-14 |
| Last Update Date | 2021-11-15 |