| NPI | 1346222551 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CT 048325) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX M7129) |
| Enumeration Date | 2005-11-15 |
| Last Update Date | 2014-02-05 |