| NPI | 1285849117 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 244820) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: DC MD039151) |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2021-06-05 |