| NPI | 1972588663 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX M0694) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 301143) |
| Enumeration Date | 2005-12-14 |
| Last Update Date | 2019-09-27 |