| NPI | 1932057072 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX U6961) |
| Additional Taxonomies | 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: TX U6961) |
| Enumeration Date | 2026-03-16 |
| Last Update Date | 2026-03-16 |