| NPI | 1295994549 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: UT 377898-1204) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX N0708) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX N0708) | |
| Enumeration Date | 2008-06-03 |
| Last Update Date | 2019-09-03 |