| NPI | 1598108136 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX R5504) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ 52687) |
| Enumeration Date | 2013-04-13 |
| Last Update Date | 2018-09-19 |