| NPI | 1316352628 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX R3956) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MT206024) |
| Enumeration Date | 2014-06-25 |
| Last Update Date | 2024-09-19 |