| NPI | 1730683921 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NE 33331) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX S6596) |
| Enumeration Date | 2018-03-21 |
| Last Update Date | 2021-07-13 |