| NPI | 1619132826 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA 71494) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX P1750) |
| Enumeration Date | 2008-07-28 |
| Last Update Date | 2014-07-31 |