| NPI | 1215037338 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX R5406) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 010051) |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2026-08-22 |