| NPI | 1841794120 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OK 7217) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX T3396) |
| Enumeration Date | 2018-03-21 |
| Last Update Date | 2025-12-22 |