| NPI | 1598706384 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX N0199) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TN 1625) |
| Enumeration Date | 2006-06-10 |
| Last Update Date | 2009-02-02 |