| NPI | 1023308178 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX Q3313) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 301405-01) |
| 207P00000X Emergency Medicine (Licence: NJ 25MA10732600) | |
| Enumeration Date | 2011-04-11 |
| Last Update Date | 2020-07-07 |