| NPI | 1467710798 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX P7426) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX 565330) |
| Enumeration Date | 2012-04-24 |
| Last Update Date | 2014-03-25 |