| NPI | 1104086586 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KS 32991) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX M5739) |
| Enumeration Date | 2008-06-10 |
| Last Update Date | 2014-03-19 |