| NPI | 1932248366 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX N6929) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX BP10026995) |
| Enumeration Date | 2007-02-05 |
| Last Update Date | 2017-11-07 |