| NPI | 1407854524 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 235608) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CT 042245) |
| Enumeration Date | 2005-07-12 |
| Last Update Date | 2007-07-08 |