| NPI | 1750351763 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL U2453) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 4881562) |
| 207P00000X Emergency Medicine (Licence: TX U2453) | |
| Enumeration Date | 2006-01-23 |
| Last Update Date | 2024-07-10 |