| NPI | 1649660846 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: UT 13264557-1205) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX S2666) |
| Enumeration Date | 2015-01-27 |
| Last Update Date | 2023-05-24 |