| NPI | 1619313608 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX Q8395) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NC 191648) |
| Enumeration Date | 2013-05-16 |
| Last Update Date | 2024-09-25 |