| NPI | 1346582814 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX R0999) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 283295-1) |
| Enumeration Date | 2013-03-22 |
| Last Update Date | 2017-04-19 |