NPI | 1114217338 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX P8611) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: LA 308207) |
207P00000X Emergency Medicine (Licence: AZ 55160) | |
Enumeration Date | 2011-04-08 |
Last Update Date | 2025-08-18 |