| NPI | 1851444384 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A73505) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 232008) |
| Enumeration Date | 2007-01-19 |
| Last Update Date | 2012-05-12 |