| NPI | 1972718757 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: TX N3637) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX N3637) |
| 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: TX N3637) | |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2019-11-18 |