| NPI | 1295925691 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PR 008922) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CO 24800) |
| 207P00000X Emergency Medicine (Licence: NY 154145-1) | |
| Enumeration Date | 2007-07-31 |
| Last Update Date | 2014-06-26 |