| NPI | 1083622484 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 236924-1) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CO 44510) |
| Enumeration Date | 2006-08-03 |
| Last Update Date | 2009-02-10 |