| NPI | 1942837257 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX W1568) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME156560) |
| Enumeration Date | 2020-03-25 |
| Last Update Date | 2026-01-14 |