| NPI | 1790030906 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX P4924) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX P4294) |
| Enumeration Date | 2012-07-13 |
| Last Update Date | 2015-11-16 |