| NPI | 1952551145 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX P7944) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PR 20182) |
| Enumeration Date | 2008-09-24 |
| Last Update Date | 2014-05-05 |