| NPI | 1093914715 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NH T-0475) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: ME 018300) |
| Enumeration Date | 2007-07-12 |
| Last Update Date | 2010-07-14 |