| NPI | 1982716957 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX K8171) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX TXBK8171) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2022-04-12 |