| NPI | 1457571804 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX N6872) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MT185995) |
| 207P00000X Emergency Medicine (Licence: NY 248848) | |
| Enumeration Date | 2007-04-26 |
| Last Update Date | 2012-08-15 |