| NPI | 1801152939 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX T1324) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 282312) |
| Enumeration Date | 2012-04-03 |
| Last Update Date | 2022-01-25 |