| NPI | 1225074966 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: CT 033777) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CT 033777) |
| Enumeration Date | 2006-06-21 |
| Last Update Date | 2012-01-30 |