| NPI | 1184691214 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX F4638) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KS 0531753) |
| Enumeration Date | 2006-03-07 |
| Last Update Date | 2014-07-31 |