| NPI | 1144296237 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX M9328) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MA 219804) |
| Enumeration Date | 2006-02-27 |
| Last Update Date | 2014-08-14 |