| NPI | 1346620598 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX R1667) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX BP10052957) |
| Enumeration Date | 2015-06-03 |
| Last Update Date | 2021-04-16 |