| NPI | 1285053827 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX R4150) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CO DR.0065421) |
| Enumeration Date | 2014-04-10 |
| Last Update Date | 2021-12-20 |