| NPI | 1649433210 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 251045) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX P365) |
| Enumeration Date | 2008-07-03 |
| Last Update Date | 2014-08-06 |