| NPI | 1477745644 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: AR E-6938) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX r0048) |
| Enumeration Date | 2007-08-13 |
| Last Update Date | 2021-01-19 |