| NPI | 1013170315 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 4301092920) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 262012) |
| Enumeration Date | 2008-07-07 |
| Last Update Date | 2016-06-10 |