| NPI | 1528164241 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME114494) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 241435) |
| Enumeration Date | 2006-09-16 |
| Last Update Date | 2015-08-26 |