| NPI | 1265413371 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AL 0025757) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX N1449) |
| Enumeration Date | 2005-11-07 |
| Last Update Date | 2010-07-15 |