| NPI | 1013545433 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: UT 14250379-1204) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NV DO3341) |
| Enumeration Date | 2020-03-31 |
| Last Update Date | 2025-11-17 |