| NPI | 1184827834 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX M6870) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MT184215) |
| Enumeration Date | 2007-06-08 |
| Last Update Date | 2015-10-16 |