| NPI | 1275563058 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX T1484) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA A88839) |
| Enumeration Date | 2006-07-04 |
| Last Update Date | 2024-04-29 |