| NPI | 1669449120 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX P2232) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OR MD26559) |
| Enumeration Date | 2006-03-03 |
| Last Update Date | 2023-06-23 |