| NPI | 1376769026 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MS 20629) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TN DO 2036) |
| 207P00000X Emergency Medicine (Licence: AR E-8234) | |
| 207P00000X Emergency Medicine (Licence: TX P-7827) | |
| Enumeration Date | 2007-04-18 |
| Last Update Date | 2014-07-01 |