| NPI | 1144487109 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX P3673) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA OT012334) |
| Enumeration Date | 2008-05-19 |
| Last Update Date | 2020-02-26 |