| NPI | 1689699076 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 4301034792) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX F2958) |
| 207P00000X Emergency Medicine (Licence: NY 117904) | |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2010-12-03 |