| NPI | 1487001962 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX R4447) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX BP10057653) |
| Enumeration Date | 2016-05-16 |
| Last Update Date | 2018-03-15 |