| NPI | 1417279662 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 247566) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NY 045894) |
| Enumeration Date | 2010-02-15 |
| Last Update Date | 2010-02-18 |