| NPI | 1225052558 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: AK M3290) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX M3290) |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2012-10-17 |