| NPI | 1376705525 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 265722) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME152703) |
| Enumeration Date | 2008-06-30 |
| Last Update Date | 2023-03-17 |