| NPI | 1851754642 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX S1589) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA A162263) |
| 207P00000X Emergency Medicine (Licence: MO 2019020165) | |
| 207P00000X Emergency Medicine (Licence: AZ 58192) | |
| 207P00000X Emergency Medicine (Licence: KS 04-42482) | |
| 208D00000X General Practice (Licence: TX S1589) | |
| Enumeration Date | 2016-03-30 |
| Last Update Date | 2021-05-27 |