| NPI | 1952343139 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX P4657) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME90677) |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2020-04-09 |