| NPI | 1013368042 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: TX S5217) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MO 2016022456) |
| Enumeration Date | 2016-06-30 |
| Last Update Date | 2023-02-20 |