| NPI | 1972528289 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX N0293) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OK 4318) |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2015-03-16 |