| NPI | 1457500936 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: UT 7534777-1204) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 252261) |
| Enumeration Date | 2008-09-09 |
| Last Update Date | 2010-06-04 |