| NPI | 1558895409 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX S7871) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NC 227325) |
| 207P00000X Emergency Medicine (Licence: AZ 71634) | |
| Enumeration Date | 2017-04-18 |
| Last Update Date | 2024-02-05 |