| NPI | 1306022959 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A104525) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 239509) |
| Enumeration Date | 2008-01-14 |
| Last Update Date | 2008-11-25 |