| NPI | 1063851673 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 320332) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MT203453) |
| 207P00000X Emergency Medicine (Licence: FL ME131124) | |
| Enumeration Date | 2013-06-17 |
| Last Update Date | 2023-03-30 |