| NPI | 1255658555 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX P3687) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35135722) |
| 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: OH 35135722) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: TX P3687) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2010-04-26 |
| Last Update Date | 2021-07-28 |