| NPI | 1700082260 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AZ 006552) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX P3397) |
| 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: TX P3397) | |
| 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: AZ 006552) | |
| Enumeration Date | 2007-06-22 |
| Last Update Date | 2021-12-21 |