| NPI | 1205457041 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX T6927) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX BP10070684) |
| Enumeration Date | 2020-05-04 |
| Last Update Date | 2022-08-10 |