| NPI | 1366947095 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX T1989) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA 165883) |
| Enumeration Date | 2018-03-26 |
| Last Update Date | 2022-01-05 |