| NPI | 1225480015 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME171495) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX S1378) |
| Enumeration Date | 2016-07-06 |
| Last Update Date | 2025-05-08 |