| NPI | 1982024881 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX S5056) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MO 2018005683) |
| Enumeration Date | 2014-04-18 |
| Last Update Date | 2020-06-24 |