| NPI | 1316248594 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX Q5483) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME117853) |
| Enumeration Date | 2010-11-04 |
| Last Update Date | 2024-09-19 |