| NPI | 1508136847 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA 20a12330) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX p1323) |
| Enumeration Date | 2012-01-04 |
| Last Update Date | 2021-12-02 |