| NPI | 1033196043 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: TX N4500) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MS 16616) |
| Enumeration Date | 2005-12-30 |
| Last Update Date | 2024-09-05 |