| NPI | 1811561392 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX 726676) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX U4739) |
| Enumeration Date | 2021-05-18 |
| Last Update Date | 2023-06-19 |