NPI | 1225133085 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX L9162) |
Additional Taxonomies | 282N00000X General Acute Care Hospital (Licence: LA 200791) |
Enumeration Date | 2006-09-14 |
Last Update Date | 2018-03-17 |