| NPI | 1215997507 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX P0820) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 226656) |
| Enumeration Date | 2006-03-23 |
| Last Update Date | 2011-12-05 |