| NPI | 1730221151 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: RI 12238) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX P4839) |
| Enumeration Date | 2007-02-13 |
| Last Update Date | 2026-03-11 |