| NPI | 1043354269 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX P7431) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CO 45645) |
| Enumeration Date | 2007-02-19 |
| Last Update Date | 2014-01-18 |