| NPI | 1265466262 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX M9976) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 531134) |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2010-02-16 |