| NPI | 1063737666 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: UT 8895752-1205) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MA 250647) |
| Enumeration Date | 2010-04-07 |
| Last Update Date | 2015-08-20 |