| NPI | 1093813255 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CT 57148) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME 108673) |
| 207P00000X Emergency Medicine (Licence: NM MD2017-0905) | |
| 207P00000X Emergency Medicine (Licence: NJ 25MA07677100) | |
| 207P00000X Emergency Medicine (Licence: NY 224076) | |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2022-02-28 |