| NPI | 1417991480 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX P4198) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MD D44291) |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2022-05-25 |