| NPI | 1720020373 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX M8587) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MS 17545) |
| Enumeration Date | 2006-06-11 |
| Last Update Date | 2010-11-11 |