| NPI | 1568756765 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX Q3522) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MD453173) |
| Enumeration Date | 2011-06-06 |
| Last Update Date | 2024-09-16 |