| NPI | 1124035845 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: TX R9212) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: IN 01051319A) |
| Enumeration Date | 2006-08-02 |
| Last Update Date | 2022-01-25 |