| NPI | 1659647832 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX P7466) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX 565332) |
| Enumeration Date | 2012-04-01 |
| Last Update Date | 2020-11-09 |