| NPI | 1093732620 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: TX G5506) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX G5506) |
| 207P00000X Emergency Medicine (Licence: TX G5506) | |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2025-01-15 |