| NPI | 1134179484 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: UT 30827491205) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX H6143) |
| 207R00000X Internal Medicine (Licence: TX H6143) | |
| 207P00000X Emergency Medicine (Licence: UT 3082749-1205) | |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2016-07-27 |