| NPI | 1073536447 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX Q2533) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IN 01060466A) |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2019-11-22 |