| NPI | 1518296185 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX P7956)  | 
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NM MD2013-0686)  | 
| Enumeration Date | 2009-12-10 | 
| Last Update Date | 2024-09-26 |