| NPI | 1649621574 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AL MD.38424) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX R5215) |
| 207P00000X Emergency Medicine (Licence: TX BP10057669) | |
| Enumeration Date | 2016-06-22 |
| Last Update Date | 2019-08-05 |