| NPI | 1417343724 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AR T2020-365) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX R6192) |
| Enumeration Date | 2015-04-13 |
| Last Update Date | 2020-08-27 |