| NPI | 1720473291 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX S0900) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CO DR.0059777) |
| Enumeration Date | 2015-04-01 |
| Last Update Date | 2019-12-06 |