| NPI | 1235428525 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NV 15231) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 273327) |
| 207P00000X Emergency Medicine (Licence: CA 129570) | |
| Enumeration Date | 2011-04-07 |
| Last Update Date | 2015-01-24 |