| NPI | 1518487701 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX R8684) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ 010733) |
| Enumeration Date | 2017-06-20 |
| Last Update Date | 2024-06-17 |