| NPI | 1407241433 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MO 2020033141) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX R6774) |
| Enumeration Date | 2015-04-06 |
| Last Update Date | 2021-01-14 |