| NPI | 1134502008 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX R3102) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OK R0089) |
| Enumeration Date | 2015-07-09 |
| Last Update Date | 2024-09-17 |