| NPI | 1508121849 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX BS5127091-972) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: HI MD-21642) |
| Enumeration Date | 2012-07-12 |
| Last Update Date | 2026-07-16 |