| NPI | 1699068601 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA 140040) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX Q3901) |
| Enumeration Date | 2011-05-24 |
| Last Update Date | 2020-07-06 |