| NPI | 1376861401 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX P1569) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX BP10037125) |
| Enumeration Date | 2010-05-13 |
| Last Update Date | 2012-05-24 |