| NPI | 1922258938 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX P2207) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 247573) |
| Enumeration Date | 2008-09-26 |
| Last Update Date | 2018-08-03 |