| NPI | 1831162700 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX M4459) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MN 46832) |
| Enumeration Date | 2006-02-09 |
| Last Update Date | 2013-03-19 |