| NPI | 1841359189 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX M5995) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NV 869) |
| Enumeration Date | 2006-12-06 |
| Last Update Date | 2016-03-07 |