| NPI | 1710621990 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX V0837) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX BP10080036) |
| Enumeration Date | 2022-04-25 |
| Last Update Date | 2024-05-20 |