| NPI | 1922103464 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX N4716) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL me87641) |
| Enumeration Date | 2006-09-13 |
| Last Update Date | 2014-11-19 |