| NPI | 1629361514 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX P9680) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA A122175) |
| Enumeration Date | 2011-05-25 |
| Last Update Date | 2015-03-16 |