| NPI | 1770158057 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OR DO219574) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX U1534) |
| 207P00000X Emergency Medicine (Licence: TX BP1726671) | |
| Enumeration Date | 2021-05-20 |
| Last Update Date | 2024-05-07 |