| NPI | 1972951408 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX R4427) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX BP10057638) |
| Enumeration Date | 2016-05-25 |
| Last Update Date | 2022-01-27 |