| NPI | 1851385496 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: TX J5341) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NM 87-243) |
| Enumeration Date | 2005-09-09 |
| Last Update Date | 2024-12-10 |