| NPI | 1477012235 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX T5808) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NC 250025) |
| Enumeration Date | 2019-03-19 |
| Last Update Date | 2022-08-01 |