| NPI | 1043235344 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX N4729) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MO 2006015405) |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2015-04-29 |