| NPI | 1205579042 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX V1433) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX BP10080030) |
| Enumeration Date | 2022-04-19 |
| Last Update Date | 2024-06-10 |