| NPI | 1154347839 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX K5834) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CO 41323) |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2025-06-24 |