| NPI | 1144394206 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KY 03164) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX M5446) |
| Enumeration Date | 2006-11-20 |
| Last Update Date | 2025-10-07 |