| NPI | 1003175233 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX Q8371) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL TRN17251) |
| Enumeration Date | 2012-05-08 |
| Last Update Date | 2016-11-29 |