| NPI | 1356751424 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX Q7209) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX BP10050379) |
| Enumeration Date | 2014-04-29 |
| Last Update Date | 2016-10-05 |