| NPI | 1518254028 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MA10444200) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 71913) |
| 207P00000X Emergency Medicine (Licence: FL ME119469) | |
| 207P00000X Emergency Medicine (Licence: NY 271915) | |
| Enumeration Date | 2011-07-05 |
| Last Update Date | 2023-06-09 |