| NPI | 1326368150 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX BP10037424) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX P4776) |
| Enumeration Date | 2010-06-03 |
| Last Update Date | 2013-03-06 |