| NPI | 1336288323 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 2604861) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NM 2006-0360) |
| 207P00000X Emergency Medicine (Licence: CA A108735) | |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2011-12-21 |