| NPI | 1922340074 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NM A-1877-15) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX Q8422) |
| Enumeration Date | 2013-03-26 |
| Last Update Date | 2021-06-14 |