| NPI | 1114239399 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 255897) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME107827) |
| Enumeration Date | 2010-07-05 |
| Last Update Date | 2010-10-26 |