| NPI | 1275713703 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AZ 37717) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 246764) |
| Enumeration Date | 2007-11-13 |
| Last Update Date | 2009-05-19 |