| NPI | 1760585194 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX M9896) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VA 0101239139) |
| Enumeration Date | 2006-09-07 |
| Last Update Date | 2014-10-24 |