| NPI | 1184751547 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: UT 7795038-1205) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX M6405) |
| Enumeration Date | 2007-02-27 |
| Last Update Date | 2019-09-21 |