| NPI | 1609337732 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX U8554) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 315345) |
| Enumeration Date | 2019-03-29 |
| Last Update Date | 2024-07-03 |