| NPI | 1144759598 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX U1056) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA OS021043) |
| Enumeration Date | 2017-06-08 |
| Last Update Date | 2026-03-11 |