| NPI | 1487896288 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA 67412) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX S2283) |
| 207P00000X Emergency Medicine (Licence: CA A142981) | |
| Enumeration Date | 2009-03-26 |
| Last Update Date | 2020-02-12 |