| NPI | 1629183306 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX P3937) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA 20A7786) |
| 207P00000X Emergency Medicine (Licence: GA 058990) | |
| 207P00000X Emergency Medicine (Licence: MT 11330) | |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2012-09-28 |