| NPI | 1073545588 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX M6179) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: LA 13632R) |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2008-03-11 |