| NPI | 1487679734 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0101232218) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 209086) |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2008-02-20 |