| NPI | 1265626006 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SC 36493) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX N6894) |
| Enumeration Date | 2007-09-05 |
| Last Update Date | 2025-11-21 |