| NPI | 1205152220 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX Q6518) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA A125508) |
| Enumeration Date | 2010-04-15 |
| Last Update Date | 2024-09-17 |