| NPI | 1518184225 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME 98362) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 242737) |
| Enumeration Date | 2007-04-20 |
| Last Update Date | 2021-03-25 |