| NPI | 1205375839 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA 85535) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX S0443) |
| Enumeration Date | 2017-02-15 |
| Last Update Date | 2020-07-06 |