| NPI | 1851475453 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CT 51942) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 217226) |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2013-07-18 |