| NPI | 1437387255 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX T4838) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NJ MA06955400) |
| 207P00000X Emergency Medicine (Licence: OK 30111) | |
| Enumeration Date | 2009-07-01 |
| Last Update Date | 2022-10-06 |