| NPI | 1982625752 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: TX M1346) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 225083) |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2008-12-12 |