| NPI | 1962745687 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX S0682) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA A135066) |
| Enumeration Date | 2013-04-01 |
| Last Update Date | 2020-04-14 |