| NPI | 1205159605 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX R7051) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: DC MD038497) |
| Enumeration Date | 2010-03-12 |
| Last Update Date | 2021-01-09 |