| NPI | 1376071357 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OR MD198197) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX BP10061467) |
| Enumeration Date | 2017-06-02 |
| Last Update Date | 2020-08-13 |