| NPI | 1356536890 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 252817) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA OS013623) |
| Enumeration Date | 2007-09-07 |
| Last Update Date | 2016-06-13 |