| NPI | 1396181285 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX Q2198) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX BP10047340) |
| Enumeration Date | 2013-05-17 |
| Last Update Date | 2020-11-02 |