| NPI | 1750726568 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AL MD.37068) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX Q8330) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX 575333) | |
| Enumeration Date | 2013-05-07 |
| Last Update Date | 2022-01-07 |