| NPI | 1558381483 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CT 043179) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 220219) |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2007-08-13 |