| NPI | 1861463481 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX F1962) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA C40302) |
| Enumeration Date | 2006-01-31 |
| Last Update Date | 2013-08-08 |