| NPI | 1992075246 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 270852) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA 198342) |
| 207P00000X Emergency Medicine (Licence: CA 129498) | |
| Enumeration Date | 2012-01-04 |
| Last Update Date | 2014-06-06 |