| NPI | 1427071588 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A70394) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX Q4566) |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2025-08-06 |