| NPI | 1780326710 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX V5523) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX BP10078501) |
| Enumeration Date | 2022-04-11 |
| Last Update Date | 2025-01-23 |