| NPI | 1881826311 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: MD DO75677) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX R6644) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2009-08-17 |
| Last Update Date | 2024-08-08 |