| NPI | 1902876725 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX N5492) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: TX PA02380) |
| 207P00000X Emergency Medicine (Licence: NY 253504) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2006-01-24 |
| Last Update Date | 2017-11-07 |