| NPI | 1457705642 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: ID M-17036) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX S2313) |
| Enumeration Date | 2016-04-14 |
| Last Update Date | 2023-10-19 |