| NPI | 1194345694 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX U3924) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NE 34208) |
| Enumeration Date | 2020-04-24 |
| Last Update Date | 2025-11-10 |