| NPI | 1508253881 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX S8341) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 036150489) |
| 207P00000X Emergency Medicine (Licence: MO 2019024451) | |
| 207P00000X Emergency Medicine (Licence: IN 01082466A) | |
| Enumeration Date | 2015-04-23 |
| Last Update Date | 2026-04-22 |