| NPI | 1750670451 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA C175789) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX P9024) |
| 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: TX P9024) | |
| Enumeration Date | 2011-04-04 |
| Last Update Date | 2024-04-15 |