| NPI | 1336487834 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX R7716) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NE 28034) |
| 207P00000X Emergency Medicine (Licence: TN 57918) | |
| Enumeration Date | 2013-01-18 |
| Last Update Date | 2024-04-16 |