| NPI | 1922561588 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A176224) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX S9335) |
| Enumeration Date | 2019-04-10 |
| Last Update Date | 2023-03-07 |