| NPI | 1316117583 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A114547) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 241232) |
| Enumeration Date | 2008-03-04 |
| Last Update Date | 2013-08-22 |