| NPI | 1619232832 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SC 51993) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX P3225) |
| Enumeration Date | 2012-07-13 |
| Last Update Date | 2021-05-20 |