| NPI | 1760894497 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX R2054) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL TRN20266) |
| Enumeration Date | 2014-05-29 |
| Last Update Date | 2023-02-02 |