| NPI | 1366880015 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX R2565) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX P02503086) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-06-04 |
| Last Update Date | 2023-11-27 |