| NPI | 1992863971 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX M7020) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 238603) |
| Enumeration Date | 2006-12-04 |
| Last Update Date | 2009-06-02 |