| NPI | 1285648493 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX R8420) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 38045) |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2018-08-03 |