| NPI | 1730150574 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX L4391) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX L4391) |
| Enumeration Date | 2006-01-30 |
| Last Update Date | 2007-07-08 |