| NPI | 1417306952 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: LA 312427) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX R5704) |
| 207P00000X Emergency Medicine (Licence: TX BP10057575) | |
| Enumeration Date | 2016-06-06 |
| Last Update Date | 2019-07-31 |