| NPI | 1194701037 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 35.078822) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX L4541) |
| 207P00000X Emergency Medicine (Licence: CO 47012) | |
| Enumeration Date | 2005-12-22 |
| Last Update Date | 2009-08-07 |