| NPI | 1629022892 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: TX N2182) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NJ 25MA08049600) |
| Enumeration Date | 2006-05-20 |
| Last Update Date | 2015-01-01 |