| NPI | 1851911663 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: UT 13293675-1205) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX T7555) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX BP10070594) | |
| Enumeration Date | 2020-04-22 |
| Last Update Date | 2023-08-23 |