| NPI | 1871723932 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX P3770) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301094555) |
| Enumeration Date | 2009-07-22 |
| Last Update Date | 2013-03-07 |