| NPI | 1891753232 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX P7380) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: HI 13157) |
| 207P00000X Emergency Medicine (Licence: CA A103638) | |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2014-02-05 |