| NPI | 1295785053 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MD D0067779) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX M7510) |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2010-04-07 |