| NPI | 1992796585 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX N3101) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TN 28601) |
| Enumeration Date | 2005-11-02 |
| Last Update Date | 2019-03-07 |