| NPI | 1073741211 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TN 54045) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX P5391) |
| Enumeration Date | 2009-06-25 |
| Last Update Date | 2022-03-23 |