| NPI | 1316130040 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX FTL41872) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX N0903) |
| Enumeration Date | 2007-08-27 |
| Last Update Date | 2015-11-16 |