| NPI | 1346348505 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX N3812) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NJ 25MA08088400) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2024-09-17 |