| NPI | 1376508010 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A105987) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 235903) |
| Enumeration Date | 2006-04-18 |
| Last Update Date | 2017-12-19 |