| NPI | 1265069702 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: LA 331210) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX T9819) |
| Enumeration Date | 2020-03-25 |
| Last Update Date | 2022-12-20 |