| NPI | 1144472531 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX P4086) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 247454) |
| Enumeration Date | 2008-10-16 |
| Last Update Date | 2023-01-26 |