| NPI | 1538401955 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX R2089) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 283503) |
| Enumeration Date | 2013-03-24 |
| Last Update Date | 2017-04-24 |