| NPI | 1194745885 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AZ 005432) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX P8586) |
| 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: IN 02003009A) | |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2025-10-10 |