| NPI | 1396249744 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX S8507) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VA 0101268663) |
| Enumeration Date | 2018-03-21 |
| Last Update Date | 2023-04-06 |