| NPI | 1790903292 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 195593) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: LA DO.00197) |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2012-10-15 |