| NPI | 1548720600 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WI 82895-020) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX T1771) |
| 207P00000X Emergency Medicine (Licence: IL 036160141) | |
| Enumeration Date | 2019-03-23 |
| Last Update Date | 2026-07-30 |