| NPI | 1417189184 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX N4780) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 254392) |
| Enumeration Date | 2009-08-14 |
| Last Update Date | 2022-12-02 |