| NPI | 1639268121 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: UT 363890-1205) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MA 222533) |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2007-12-27 |