NPI | 1497191621 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX R1132) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 5101020469) |
Enumeration Date | 2013-05-15 |
Last Update Date | 2018-03-23 |