| NPI | 1508826066 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NM MD2004-0669) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX L1345) |
| Enumeration Date | 2006-03-27 |
| Last Update Date | 2019-05-30 |