| NPI | 1477518710 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NM MD2013-0163) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WY 15623C) |
| 207P00000X Emergency Medicine (Licence: TX M1605) | |
| 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: TX M1605) | |
| Enumeration Date | 2006-04-19 |
| Last Update Date | 2024-03-05 |