| NPI | 1780623496 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL os 9730) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 237574) |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2008-01-18 |