| NPI | 1376038877 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX U4251) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AR E-14455) |
| Enumeration Date | 2018-06-27 |
| Last Update Date | 2023-09-01 |