| NPI | 1023376738 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX R1033) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NJ 25MA09703200) |
| Enumeration Date | 2012-05-01 |
| Last Update Date | 2020-04-07 |