| NPI | 1033153267 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX Q0792) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA G77714) |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2026-02-06 |