| NPI | 1295766756 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SC 30459) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NJ 25MA07819300) |
| 207P00000X Emergency Medicine (Licence: NC 2008-01886) | |
| 207P00000X Emergency Medicine (Licence: NY 207860) | |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2012-01-22 |