| NPI | 1134235260 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX N1546) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA C135829) |
| Enumeration Date | 2006-08-22 |
| Last Update Date | 2022-05-26 |