| NPI | 1316914740 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 130191) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME107266) |
| 207P00000X Emergency Medicine (Licence: HI 15628) | |
| Enumeration Date | 2006-03-03 |
| Last Update Date | 2011-10-04 |