| NPI | 1740548007 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A122088) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX Q4636) |
| Enumeration Date | 2012-04-24 |
| Last Update Date | 2025-06-23 |