| NPI | 1720494230 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX R3443) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MN 59594) |
| Enumeration Date | 2014-07-03 |
| Last Update Date | 2018-03-17 |