| NPI | 1992150460 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX V2343) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME139023) |
| Enumeration Date | 2016-05-03 |
| Last Update Date | 2025-04-09 |