| NPI | 1376501718 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX S7330) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA md424699) |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2026-03-23 |