| NPI | 1033398912 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX S2661) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301086363) |
| Enumeration Date | 2007-10-29 |
| Last Update Date | 2026-02-24 |