| NPI | 1922426337 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 320839) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX R2108) |
| Enumeration Date | 2014-04-02 |
| Last Update Date | 2023-05-24 |