| NPI | 1255534988 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA OS016399) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IN 11013315a) |
| 207P00000X Emergency Medicine (Licence: TX P0341) | |
| Enumeration Date | 2007-06-08 |
| Last Update Date | 2013-06-03 |