| NPI | 1619948742 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX M4003) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME88463) |
| Enumeration Date | 2006-01-27 |
| Last Update Date | 2023-04-07 |