| NPI | 1770146607 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX U2671) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OK 7055) |
| Enumeration Date | 2019-04-16 |
| Last Update Date | 2026-02-02 |