| NPI | 1073584066 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX P1082) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VA 0101233544) |
| 207P00000X Emergency Medicine (Licence: CA A101797) | |
| Enumeration Date | 2006-01-30 |
| Last Update Date | 2012-05-21 |