| NPI | 1396903365 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: ID M-11321) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX N3713) |
| Enumeration Date | 2008-05-27 |
| Last Update Date | 2025-06-05 |