| NPI | 1295114577 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: ID O-1611) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX R0781) |
| Enumeration Date | 2015-05-20 |
| Last Update Date | 2022-05-05 |