| NPI | 1376738286 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX N5833) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX BP10028121) |
| Enumeration Date | 2007-09-13 |
| Last Update Date | 2013-06-25 |