| NPI | 1952711079 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX BP10050635) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX Q6793) |
| Enumeration Date | 2014-04-28 |
| Last Update Date | 2026-03-17 |