| NPI | 1457371098 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CT 036920) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 209571-1) |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2015-02-24 |