| NPI | 1942512934 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX P5522) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301096706) |
| Enumeration Date | 2010-07-08 |
| Last Update Date | 2025-03-28 |