| NPI | 1265544217 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX K9761) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX TBXK9761) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2015-02-11 |