| NPI | 1992731137 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX H3335) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MD D0054261) |
| Enumeration Date | 2006-06-22 |
| Last Update Date | 2008-09-25 |