| NPI | 1205095494 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MO 2023011249) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX N6004) |
| Enumeration Date | 2008-06-03 |
| Last Update Date | 2026-05-14 |