| NPI | 1073642914 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: UT 330938-1205) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NC 2009-00281) |
| Enumeration Date | 2007-03-05 |
| Last Update Date | 2016-05-20 |