| NPI | 1831322072 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME106205) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 249244) |
| Enumeration Date | 2009-09-03 |
| Last Update Date | 2010-09-29 |