| NPI | 1013000751 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AZ 47189) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 235662) |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2014-06-13 |