| NPI | 1528645215 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX U3992) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 328426) |
| Enumeration Date | 2021-03-27 |
| Last Update Date | 2026-01-23 |