| NPI | 1801201496 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: UT 156895-1205) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX D4939) |
| 207P00000X Emergency Medicine (Licence: CA C31759) | |
| Enumeration Date | 2014-06-23 |
| Last Update Date | 2014-06-23 |