| NPI | 1194071266 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX Q4395) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: LA 310271) |
| Enumeration Date | 2012-07-26 |
| Last Update Date | 2018-10-24 |