| NPI | 1306160759 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 256301) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA A113S12) |
| Enumeration Date | 2010-03-15 |
| Last Update Date | 2011-08-04 |