| NPI | 1508183617 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 269804) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME) |
| Enumeration Date | 2010-04-28 |
| Last Update Date | 2016-02-11 |