| NPI | 1942415724 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX N6138) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MD434761) |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2010-08-13 |