| NPI | 1295752897 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A83025)  | 
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX L4765)  | 
| Enumeration Date | 2006-07-17 | 
| Last Update Date | 2024-05-22 |