| NPI | 1619137098 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX P5332) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MD D70180) |
| Enumeration Date | 2008-06-10 |
| Last Update Date | 2013-04-22 |