| NPI | 1558689315 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: TX P6390) |
| Additional Taxonomies | 207PT0002X Emergency Medicine, Medical Toxicology (Licence: TX P6390) |
| Enumeration Date | 2010-05-04 |
| Last Update Date | 2017-10-06 |