| NPI | 1619314036 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: ID O-1947) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX Q8785) |
| Enumeration Date | 2013-05-24 |
| Last Update Date | 2025-02-05 |