| NPI | 1386947109 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX T7446) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TN MD51790) |
| 207P00000X Emergency Medicine (Licence: PA MD457468) | |
| Enumeration Date | 2010-12-16 |
| Last Update Date | 2025-07-22 |