| NPI | 1477504132 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX F4395) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CO 30775) |
| Enumeration Date | 2006-05-15 |
| Last Update Date | 2013-12-18 |