| NPI | 1588075634 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: DC MD600004278) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX R0572) |
| Enumeration Date | 2014-05-12 |
| Last Update Date | 2026-01-15 |