| NPI | 1790289262 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: LA 336297) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX T0611) |
| Enumeration Date | 2018-03-20 |
| Last Update Date | 2023-08-09 |