| NPI | 1285044651 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX Q5617) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX BP10050374) |
| Enumeration Date | 2014-05-06 |
| Last Update Date | 2021-12-06 |