| NPI | 1386756807 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A90325) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX N7146) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2019-12-12 |