| NPI | 1720076755 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: UT 6660980-1205) |
| Additional Taxonomies | 207PE0004X Emergency Medicine Emergency Medical Services (Licence: TX L0018) |
| Enumeration Date | 2005-10-13 |
| Last Update Date | 2010-09-09 |