| NPI | 1528488301 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0101259500) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX R3393) |
| Enumeration Date | 2014-04-21 |
| Last Update Date | 2020-10-06 |