| NPI | 1275565376 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY MD242121-1) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MD423830) |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2012-08-15 |