| NPI | 1194703447 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX L2558) |
| Additional Taxonomies | 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: TX L2558) |
| Enumeration Date | 2006-01-06 |
| Last Update Date | 2007-07-09 |