| NPI | 1720467947 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA C200352) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX R9149) |
| Enumeration Date | 2015-05-20 |
| Last Update Date | 2025-02-27 |