| NPI | 1932488962 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MO 2014029117) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX BP10033822) |
| Enumeration Date | 2011-08-08 |
| Last Update Date | 2014-10-23 |