| NPI | 1003020785 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX N3299) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 58001946) |
| Enumeration Date | 2007-05-10 |
| Last Update Date | 2009-09-24 |