| NPI | 1861751588 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CO DR.0074569) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA A136136) |
| 207P00000X Emergency Medicine (Licence: TX BP10042995) | |
| 207P00000X Emergency Medicine (Licence: TX Q1819) | |
| Enumeration Date | 2012-05-15 |
| Last Update Date | 2025-08-19 |