| NPI | 1225050594 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 238514) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL OS9679) |
| Enumeration Date | 2006-07-24 |
| Last Update Date | 2007-07-08 |