| NPI | 1144754615 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VT 042.0016380) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX S2330) |
| Enumeration Date | 2017-04-11 |
| Last Update Date | 2025-04-10 |