| NPI | 1194894816 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX M6831) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AR E-5014) |
| Enumeration Date | 2006-11-07 |
| Last Update Date | 2020-12-31 |