| NPI | 1518607548 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX V7279) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: TX V7279) |
| Enumeration Date | 2022-03-29 |
| Last Update Date | 2025-09-09 |