| NPI | 1902023773 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: UT 7536235-1205) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NM pending) |
| Enumeration Date | 2007-04-20 |
| Last Update Date | 2010-10-01 |