| NPI | 1841865102 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX U1859) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ 77828) |
| Enumeration Date | 2021-05-20 |
| Last Update Date | 2026-08-14 |