| NPI | 1952349458 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 252539) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WA MD00043760) |
| Enumeration Date | 2006-06-04 |
| Last Update Date | 2009-07-13 |