| NPI | 1174818348 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX P7050) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX BP10040571) |
| Enumeration Date | 2011-06-15 |
| Last Update Date | 2013-10-18 |