| NPI | 1003264375 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX S2234) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NH 25658) |
| Enumeration Date | 2016-05-27 |
| Last Update Date | 2024-05-09 |