| NPI | 1881716769 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AR E-5511) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX N0101) |
| Enumeration Date | 2007-04-04 |
| Last Update Date | 2009-11-12 |