| NPI | 1942282876 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX N5235) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AL DO-896) |
| Enumeration Date | 2005-11-16 |
| Last Update Date | 2025-10-20 |