| NPI | 1669437208 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX L8330) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 228934-1) |
| Enumeration Date | 2006-04-18 |
| Last Update Date | 2007-07-08 |