| NPI | 1316948003 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX K0999) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AR C-8458) |
| 207P00000X Emergency Medicine (Licence: OK 43000) | |
| Enumeration Date | 2005-08-03 |
| Last Update Date | 2025-10-27 |