| NPI | 1780181511 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MA 286640) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX U3653) |
| Enumeration Date | 2018-04-09 |
| Last Update Date | 2023-08-08 |