| NPI | 1093109480 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NH 22293) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 285372) |
| 207P00000X Emergency Medicine (Licence: TX R1638) | |
| Enumeration Date | 2015-03-24 |
| Last Update Date | 2022-11-07 |