| NPI | 1386723815 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX M6193) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 222071) |
| Enumeration Date | 2006-11-03 |
| Last Update Date | 2015-05-29 |