| NPI | 1205851565 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME100681) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 227844) |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2013-04-09 |