| NPI | 1992947014 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 301232-01) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX P3154) |
| Enumeration Date | 2009-04-03 |
| Last Update Date | 2021-02-12 |