| NPI | 1760528426 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX N9489) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX bp10023063) |
| Enumeration Date | 2007-01-29 |
| Last Update Date | 2011-12-07 |