| NPI | 1447245535 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME 97308) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 195018-1) |
| Enumeration Date | 2005-09-14 |
| Last Update Date | 2021-10-13 |