| NPI | 1184711269 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 226636) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CO 51548) |
| Enumeration Date | 2006-10-09 |
| Last Update Date | 2015-04-07 |