| NPI | 1407823313 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MA 261065) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: MA 261065) |
| 207P00000X Emergency Medicine (Licence: TX M1971) | |
| Enumeration Date | 2006-03-01 |
| Last Update Date | 2025-10-20 |