| NPI | 1285665422 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 239275) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA A109465) |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2021-12-21 |