| NPI | 1235399627 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX P3643) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: LA MD203840) |
| Enumeration Date | 2008-06-10 |
| Last Update Date | 2013-03-07 |