| NPI | 1689814253 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX P3849) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TN DO2212) |
| Enumeration Date | 2009-02-23 |
| Last Update Date | 2019-12-09 |