| NPI | 1689930455 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A139105) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX Q3371) |
| Enumeration Date | 2012-04-06 |
| Last Update Date | 2024-04-11 |