| NPI | 1477713154 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX Q8456) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ 011244) |
| Enumeration Date | 2008-06-16 |
| Last Update Date | 2025-04-24 |