| NPI | 1225284599 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MD D0074890) |
| Additional Taxonomies | 208600000X Surgery (Licence: NY 249344) |
| Enumeration Date | 2008-08-18 |
| Last Update Date | 2013-03-29 |