| NPI | 1396374997 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: UT 13870025-1205) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: UT 13870025-1205) |
| Enumeration Date | 2020-04-06 |
| Last Update Date | 2024-04-11 |