| NPI | 1073719100 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SC 39533) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX N7359) |
| Enumeration Date | 2007-06-25 |
| Last Update Date | 2026-04-16 |