| NPI | 1780626853 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0004X Emergency Medicine Emergency Medical Services (Licence: TX G7590) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX G7590) |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2010-05-14 |