| NPI | 1932193505 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX P0047) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: MS 14207) |
| Enumeration Date | 2005-09-09 |
| Last Update Date | 2022-11-16 |