| NPI | 1801060553 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX N7839) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NC 2010-01028) |
| Enumeration Date | 2008-04-14 |
| Last Update Date | 2011-07-01 |