| NPI | 1093159949 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX Q6588) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA OT015112) |
| Enumeration Date | 2013-04-23 |
| Last Update Date | 2016-07-18 |