| NPI | 1275766693 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX P7787) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX BP10031890) |
| 207P00000X Emergency Medicine (Licence: AL MD.31104) | |
| Enumeration Date | 2009-09-02 |
| Last Update Date | 2023-03-15 |