| NPI | 1518296185 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX P7956) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NM MD2013-0686) |
| Enumeration Date | 2009-12-10 |
| Last Update Date | 2023-11-08 |