| NPI | 1043440639 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX R1588) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 004120) |
| 207P00000X Emergency Medicine (Licence: IN 01079323A) | |
| Enumeration Date | 2009-07-17 |
| Last Update Date | 2020-04-10 |