| NPI | 1780842617 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OR MD165527) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 261096-1) |
| Enumeration Date | 2008-05-28 |
| Last Update Date | 2014-08-26 |