| NPI | 1659658128 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX U9812) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 274266) |
| Enumeration Date | 2011-11-10 |
| Last Update Date | 2024-08-09 |