| NPI | 1225391295 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX R2046) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 2832991) |
| Enumeration Date | 2012-06-24 |
| Last Update Date | 2025-09-19 |