| NPI | 1467018762 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A177216) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX 697332) |
| Enumeration Date | 2019-05-13 |
| Last Update Date | 2024-05-29 |