| NPI | 1811959612 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 243861) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX M0691) |
| Enumeration Date | 2006-04-05 |
| Last Update Date | 2013-01-07 |