| NPI | 1881640316 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX L5929) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: LA 023903) |
| Enumeration Date | 2006-05-26 |
| Last Update Date | 2013-10-02 |