| NPI | 1750743316 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MD D0102721) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX S8179) |
| Enumeration Date | 2016-03-23 |
| Last Update Date | 2026-09-05 |