| NPI | 1215975941 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX M4735) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NJ 25MA07416700) |
| Enumeration Date | 2006-06-03 |
| Last Update Date | 2008-04-16 |