| NPI | 1295239564 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX S5617) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: SC 85646) |
| Enumeration Date | 2018-03-21 |
| Last Update Date | 2024-08-08 |