| NPI | 1427129535 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: UT 7584137-1204) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ 4249) |
| Enumeration Date | 2006-11-11 |
| Last Update Date | 2015-10-16 |