| NPI | 1649485434 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX N3839) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MT187207) |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2011-10-27 |