| NPI | 1033163993 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NC 2013-00280) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: NY 229465-1) |
| Enumeration Date | 2006-05-22 |
| Last Update Date | 2013-05-15 |