| NPI | 1295013282 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX Q3846) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NE 33135) |
| Enumeration Date | 2011-07-26 |
| Last Update Date | 2022-12-20 |