| NPI | 1235209669 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AR E-14657) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX k7952) |
| Enumeration Date | 2006-11-09 |
| Last Update Date | 2021-09-29 |