| NPI | 1811484355 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA 199607) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME147797) |
| 207P00000X Emergency Medicine (Licence: TX T3041) | |
| Enumeration Date | 2018-04-19 |
| Last Update Date | 2025-06-06 |