| NPI | 1528569951 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX T9175) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NE 31994) |
| Enumeration Date | 2018-02-21 |
| Last Update Date | 2023-10-24 |