| NPI | 1457705642 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: ID M-17036)  | 
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX S2313)  | 
| 207P00000X Emergency Medicine (Licence: CA A169082)  | |
| Enumeration Date | 2016-04-14 | 
| Last Update Date | 2024-12-26 |