| NPI | 1194714113 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX M2297) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 231533-1) |
| 207P00000X Emergency Medicine (Licence: IN 01051537) | |
| Enumeration Date | 2005-10-21 |
| Last Update Date | 2021-04-08 |