| NPI | 1407376882 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SC 90737) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 009632) |
| 207P00000X Emergency Medicine (Licence: TX S6304) | |
| Enumeration Date | 2017-06-26 |
| Last Update Date | 2025-07-22 |