| NPI | 1689615882 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: UT 6108579-2105) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 2345271) |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2007-07-09 |