| NPI | 1235333618 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX N6816) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA OS014581) |
| Enumeration Date | 2007-06-12 |
| Last Update Date | 2011-05-04 |