| NPI | 1003250051 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SC 40113) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX Q4998) |
| Enumeration Date | 2013-04-22 |
| Last Update Date | 2017-01-30 |