| NPI | 1467469015 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX N0192) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MN 48672) |
| Enumeration Date | 2006-08-02 |
| Last Update Date | 2010-11-22 |