| NPI | 1891720777 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207PE0004X Emergency Medicine Emergency Medical Services (Licence: TX M4406) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX M4406) |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2009-12-07 |