| NPI | 1487626107 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 197796) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: ME 016334) |
| Enumeration Date | 2006-02-06 |
| Last Update Date | 2007-07-08 |