| NPI | 1083940258 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AR R4054) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX L0437) |
| Enumeration Date | 2009-10-23 |
| Last Update Date | 2009-10-23 |