| NPI | 1053676403 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX Q9624) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IN 02004404A) |
| Enumeration Date | 2012-07-11 |
| Last Update Date | 2024-09-26 |