| NPI | 1245233857 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX K1159) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX K1159) |
| 207P00000X Emergency Medicine (Licence: OK 24393) | |
| 207P00000X Emergency Medicine (Licence: KS T01995) | |
| 207P00000X Emergency Medicine (Licence: WV 23559) | |
| 207P00000X Emergency Medicine (Licence: MO 2009012111) | |
| 207P00000X Emergency Medicine (Licence: IA 38632) | |
| Enumeration Date | 2005-05-27 |
| Last Update Date | 2012-02-08 |