| NPI | 1013357920 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX Q8265) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: SC LL1709) |
| Enumeration Date | 2013-06-25 |
| Last Update Date | 2018-07-09 |