| NPI | 1538554514 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX T7368) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 298445) |
| Enumeration Date | 2015-04-06 |
| Last Update Date | 2022-11-22 |