| NPI | 1225066731 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX F0429) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CO DR.0062222) |
| Enumeration Date | 2006-06-30 |
| Last Update Date | 2020-02-19 |