| NPI | 1013075977 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME116465) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX N6108) |
| Enumeration Date | 2006-12-04 |
| Last Update Date | 2014-02-26 |