| NPI | 1841208501 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX M7217) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NC 200601013) |
| Enumeration Date | 2006-08-04 |
| Last Update Date | 2009-01-29 |