| NPI | 1538208400 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX P4635) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: ME MD23554) |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2024-05-24 |