| NPI | 1396784419 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX J3543) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TN MD25894) |
| 207P00000X Emergency Medicine (Licence: TN BM2767272) | |
| Enumeration Date | 2006-06-05 |
| Last Update Date | 2021-06-08 |