| NPI | 1831544535 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX S8556) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: LA 322272) |
| Enumeration Date | 2016-04-30 |
| Last Update Date | 2024-01-09 |