| NPI | 1356738140 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX R5246) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NC 2019-00405) |
| Enumeration Date | 2015-04-20 |
| Last Update Date | 2021-12-22 |