| NPI | 1588753594 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX P3973) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 174121) |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2012-12-19 |