| NPI | 1538556006 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WI 81259) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WI 23347) |
| 207P00000X Emergency Medicine (Licence: TX R0980) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX BP10053104) | |
| Enumeration Date | 2015-04-22 |
| Last Update Date | 2023-02-02 |