| NPI | 1316030406 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL OS10017) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 219077) |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2008-03-23 |