| NPI | 1942266606 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX L9199) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME93591) |
| Enumeration Date | 2006-04-21 |
| Last Update Date | 2022-12-06 |