| NPI | 1043298946 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX P2252) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KS 0426890) |
| Enumeration Date | 2006-01-03 |
| Last Update Date | 2013-02-19 |