| NPI | 1366896060 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A181766) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX BP10057582) |
| Enumeration Date | 2016-04-19 |
| Last Update Date | 2022-09-27 |