| NPI | 1306167176 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX Q4876) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MD449013) |
| Enumeration Date | 2010-06-16 |
| Last Update Date | 2025-01-15 |