| NPI | 1871703975 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 253740) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301088661) |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2012-05-24 |