| NPI | 1881958684 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX S0464) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MD D0079060) |
| Enumeration Date | 2012-06-27 |
| Last Update Date | 2022-11-04 |