| NPI | 1922047570 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OK 18034) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX J9632) |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2026-04-24 |