| NPI | 1821445263 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A175732) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX R6910) |
| Enumeration Date | 2016-05-16 |
| Last Update Date | 2022-06-03 |