| NPI | 1477710820 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 252680) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA A110514) |
| Enumeration Date | 2008-05-21 |
| Last Update Date | 2012-08-03 |