| NPI | 1902424112 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX U6539) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 323831) |
| Enumeration Date | 2020-07-14 |
| Last Update Date | 2024-06-26 |