| NPI | 1477671634 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX N0172) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AR E-5067) |
| 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: TX N0172) | |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2008-07-30 |