| NPI | 1780674119 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX P5847) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CO 44214) |
| Enumeration Date | 2005-10-26 |
| Last Update Date | 2020-11-26 |