| NPI | 1124047410 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX P4257) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OR MD22334) |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2018-08-28 |