| NPI | 1104146216 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX P8884) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MS 20988) |
| 207P00000X Emergency Medicine (Licence: LA 204665) | |
| Enumeration Date | 2010-06-11 |
| Last Update Date | 2014-06-09 |