| NPI | 1568710770 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX P7892) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX BP10041005) |
| Enumeration Date | 2012-08-17 |
| Last Update Date | 2024-09-13 |