| NPI | 1235334871 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX N9077) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CO CDR.0006591) |
| Enumeration Date | 2007-06-15 |
| Last Update Date | 2026-08-28 |