| NPI | 1427357094 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX Q1549) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NM MD2014-0727) |
| Enumeration Date | 2011-03-22 |
| Last Update Date | 2017-01-31 |