| NPI | 1053629592 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX Q6511) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 262428) |
| Enumeration Date | 2010-09-17 |
| Last Update Date | 2019-01-30 |