| NPI | 1851348312 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 4301406119) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 285836) |
| Enumeration Date | 2006-05-30 |
| Last Update Date | 2017-04-20 |