| NPI | 1831401546 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA 20A11991) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX S4676) |
| Enumeration Date | 2010-07-10 |
| Last Update Date | 2022-01-03 |