| NPI | 1891963237 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX 8237) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA A96780) |
| 207P00000X Emergency Medicine (Licence: NV 13203) | |
| Enumeration Date | 2008-02-20 |
| Last Update Date | 2023-11-28 |