| NPI | 1306042304 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NV CL0596) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX P7632) |
| 207P00000X Emergency Medicine (Licence: NY 257567) | |
| Enumeration Date | 2007-06-26 |
| Last Update Date | 2025-02-14 |