| NPI | 1578673281 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MO 2012013852) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 239506) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2016-08-18 |