| NPI | 1578875738 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX P6057) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX BP10038474) |
| Enumeration Date | 2010-07-04 |
| Last Update Date | 2025-01-08 |