| NPI | 1780896829 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX N2237) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CO 44621) |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2016-12-01 |