| NPI | 1992739643 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AZ 36929) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MA 223782) |
| 207P00000X Emergency Medicine (Licence: TX M3910) | |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2008-06-13 |