| NPI | 1487278966 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: UT 12985840-1204) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX BP10071097) |
| Enumeration Date | 2020-06-01 |
| Last Update Date | 2023-05-30 |