| NPI | 1356795546 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX T6895) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VA 0101267170) |
| Enumeration Date | 2016-04-14 |
| Last Update Date | 2022-06-02 |