| NPI | 1427462704 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 5101021328) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX R6989) |
| Enumeration Date | 2014-06-16 |
| Last Update Date | 2026-03-13 |