| NPI | 1083765408 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA C55169) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 226122) |
| Enumeration Date | 2007-01-13 |
| Last Update Date | 2014-10-01 |