| NPI | 1780241638 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX T7148) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX BP10066789) |
| Enumeration Date | 2019-05-28 |
| Last Update Date | 2022-07-25 |