| NPI | 1215914429 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 207725-1) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: HI MD14392) |
| 207P00000X Emergency Medicine (Licence: CA C53154) | |
| Enumeration Date | 2005-12-29 |
| Last Update Date | 2021-03-31 |