| NPI | 1922294008 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX N2618) | 
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA A101354) | 
| Enumeration Date | 2007-09-21 | 
| Last Update Date | 2024-07-25 |