| NPI | 1821384967 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX Q3978) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MD451194) |
| Enumeration Date | 2011-06-28 |
| Last Update Date | 2023-12-07 |