| NPI | 1225254014 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX Q1121) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CT 51828) |
| Enumeration Date | 2007-04-18 |
| Last Update Date | 2015-02-24 |