| NPI | 1447306030 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OR MD156121) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX P9815) |
| Enumeration Date | 2007-01-26 |
| Last Update Date | 2025-05-21 |