| NPI | 1700086378 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX N2164) |
| Additional Taxonomies | 207PE0004X Emergency Medicine Emergency Medical Services (Licence: TX N2164) |
| Enumeration Date | 2007-07-23 |
| Last Update Date | 2013-02-27 |