| NPI | 1386273829 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL OS18931) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX U3602) |
| Enumeration Date | 2020-04-06 |
| Last Update Date | 2023-06-07 |