| NPI | 1184785578 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MA 239292) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 260205) |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2016-10-18 |