| NPI | 1326213588 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX P5612) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MD D0070718) |
| Enumeration Date | 2008-04-28 |
| Last Update Date | 2014-07-06 |