| NPI | 1255605952 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NE 27496) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX R8923) |
| Enumeration Date | 2012-02-28 |
| Last Update Date | 2020-06-16 |