| NPI | 1932166378 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX J6203) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WV 1798) |
| Enumeration Date | 2006-04-28 |
| Last Update Date | 2018-06-13 |