| NPI | 1306982319 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A83096) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX Q1307) |
| Enumeration Date | 2007-01-29 |
| Last Update Date | 2019-06-27 |