| NPI | 1043579535 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL os12137) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 60 265108) |
| Enumeration Date | 2012-05-03 |
| Last Update Date | 2023-01-23 |