| NPI | 1265813497 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KY 05372) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 295191) |
| 207P00000X Emergency Medicine (Licence: FL OS15871) | |
| Enumeration Date | 2015-06-12 |
| Last Update Date | 2023-11-27 |