| NPI | 1740210350 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: CA K3688) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX K3688) |
| 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: TX K3688) | |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2024-02-04 |