| NPI | 1447461157 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX H9283) |
| Additional Taxonomies | 282N00000X General Acute Care Hospital (Licence: TX TXBH9283) |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2025-10-03 |