| NPI | 1578573226 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA 054091) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 239433) |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2013-06-13 |