| NPI | 1639630064 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AZ 66357) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX T1224) |
| Enumeration Date | 2019-03-28 |
| Last Update Date | 2022-08-11 |