| NPI | 1548586787 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX Q0637) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 269515) |
| Enumeration Date | 2010-04-13 |
| Last Update Date | 2014-11-18 |