| NPI | 1669903969 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX U9717) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MS 27682) |
| Enumeration Date | 2017-03-27 |
| Last Update Date | 2024-09-11 |