| NPI | 1598023079 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX Q3917) |
| Additional Taxonomies | 2083A0300X Preventive Medicine, Addiction Medicine (Licence: TX Q3917) |
| Enumeration Date | 2012-05-02 |
| Last Update Date | 2025-11-14 |