| NPI | 1427088947 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WA MD00041961)  | 
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX T9441)  | 
| Enumeration Date | 2006-07-03 | 
| Last Update Date | 2023-09-11 |