| NPI | 1144638677 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA 20a16152) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 274346-217) |
| Enumeration Date | 2014-07-28 |
| Last Update Date | 2018-11-10 |