| NPI | 1598031858 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: UT 8935532-1204) | 
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA 20A11942) | 
| Enumeration Date | 2012-03-30 | 
| Last Update Date | 2014-07-07 |