| NPI | 1386965929 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX Q1102) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: MO 2013020291) |
| Enumeration Date | 2010-06-17 |
| Last Update Date | 2017-02-02 |