| NPI | 1922363563 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX S5745) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 282423) |
| Enumeration Date | 2012-07-10 |
| Last Update Date | 2024-03-20 |