| NPI | 1427253830 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX N3175) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: MO 2006032680) |
| Enumeration Date | 2007-06-15 |
| Last Update Date | 2019-01-30 |