| NPI | 1528402526 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX Q2439) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: UT 9743845-1204) |
| 207P00000X Emergency Medicine (Licence: TX BP10045847) | |
| Enumeration Date | 2013-04-20 |
| Last Update Date | 2020-04-08 |