| NPI | 1528026978 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: UT 8294005-1205) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX M4145) |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2017-04-20 |