| NPI | 1861489171 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX M1936) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA C55752) |
| Enumeration Date | 2005-10-03 |
| Last Update Date | 2015-05-26 |