| NPI | 1881993442 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: LA 204557) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 258481) |
| Enumeration Date | 2011-03-22 |
| Last Update Date | 2011-12-15 |