| NPI | 1700894581 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 252968) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MN 48806) |
| Enumeration Date | 2006-08-04 |
| Last Update Date | 2009-07-01 |