| NPI | 1578704557 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX p2810) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: LA 204043) |
| Enumeration Date | 2009-03-20 |
| Last Update Date | 2013-06-28 |