| NPI | 1528118163 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 169638) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME105541) |
| Enumeration Date | 2007-01-12 |
| Last Update Date | 2020-03-20 |