| NPI | 1497017958 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX Q6616) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VA 0101254772) |
| Enumeration Date | 2012-06-11 |
| Last Update Date | 2026-07-15 |