| NPI | 1437893708 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX V1577) | 
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX 20011) | 
| Enumeration Date | 2022-04-23 | 
| Last Update Date | 2024-05-30 |