| NPI | 1326149931 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX N2104) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NV 11184) |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2011-06-20 |