| NPI | 1053475632 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX K4431) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA G80680) |
| Enumeration Date | 2006-12-20 |
| Last Update Date | 2024-09-16 |