| NPI | 1467074443 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KS 05-47687) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX T7497) |
| Enumeration Date | 2020-05-12 |
| Last Update Date | 2025-02-19 |