| NPI | 1740623032 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: LA MD.207650) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX R4069) |
| Enumeration Date | 2013-04-17 |
| Last Update Date | 2023-03-07 |