| NPI | 1295807956 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX N5602) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA 20A5491) |
| Enumeration Date | 2006-11-15 |
| Last Update Date | 2012-03-20 |