| NPI | 1053538314 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX M7035) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301084101) |
| Enumeration Date | 2007-04-19 |
| Last Update Date | 2008-03-24 |