| NPI | 1003913880 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX K7761) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 34007799) |
| 207P00000X Emergency Medicine (Licence: NY 222713-1) | |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2008-02-19 |