| NPI | 1003042375 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: UT 8280012-1205) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NC 156598) |
| Enumeration Date | 2009-06-01 |
| Last Update Date | 2014-08-14 |