| NPI | 1417110438 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 255629) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NJ 25MA08981200) |
| 207P00000X Emergency Medicine (Licence: NY 255629-1) | |
| 207P00000X Emergency Medicine (Licence: PA MD440753) | |
| 207PE0005X Emergency Medicine, Undersea and Hyperbaric Medicine (Licence: PA MD440753) | |
| 207PE0005X Emergency Medicine, Undersea and Hyperbaric Medicine (Licence: NY 255629) | |
| Enumeration Date | 2008-07-09 |
| Last Update Date | 2019-10-24 |