| NPI | 1144269192 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX M7787) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: TX M7787) |
| 207P00000X Emergency Medicine (Licence: MI 5101015806) | |
| 207P00000X Emergency Medicine (Licence: AL M7787) | |
| Enumeration Date | 2006-06-05 |
| Last Update Date | 2016-05-10 |