| NPI | 1891710471 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX FTL 42805) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 220874) |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2010-06-15 |