| NPI | 1619331469 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 314356) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX S3236) |
| Enumeration Date | 2016-04-07 |
| Last Update Date | 2022-03-15 |