| NPI | 1932140613 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207PE0004X Emergency Medicine Emergency Medical Services (Licence: TX F9411) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX F9411) |
| Enumeration Date | 2006-06-10 |
| Last Update Date | 2010-06-21 |