| NPI | 1164623476 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A127711) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX M8977) |
| Enumeration Date | 2007-05-31 |
| Last Update Date | 2025-10-01 |