| NPI | 1205026390 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX P3758) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MO 2006007896) |
| Enumeration Date | 2007-07-26 |
| Last Update Date | 2014-02-26 |