| NPI | 1790066645 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MD D74263) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 262756) |
| Enumeration Date | 2011-09-06 |
| Last Update Date | 2013-02-28 |