| NPI | 1760407126 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX M3948) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME91501) |
| 207P00000X Emergency Medicine (Licence: LA MD.025071) | |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2008-04-14 |