| NPI | 1750636866 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NC 2014-02304) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX Q0494) |
| Enumeration Date | 2012-07-16 |
| Last Update Date | 2015-06-29 |