| NPI | 1770813610 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX P7135) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 5315043109) |
| Enumeration Date | 2009-12-27 |
| Last Update Date | 2024-09-17 |