| NPI | 1346407129 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CT 054323) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 260699) |
| Enumeration Date | 2008-05-20 |
| Last Update Date | 2015-08-19 |