| NPI | 1316964877 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX M1103) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 231908-1) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2014-10-02 |