| NPI | 1962533034 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 220386) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX M5690) |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2007-07-08 |