| NPI | 1528192374 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MO 2011033302) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME107637) |
| 207P00000X Emergency Medicine (Licence: NJ 25MA0464200) | |
| 207P00000X Emergency Medicine (Licence: NY 134485) | |
| Enumeration Date | 2007-03-15 |
| Last Update Date | 2024-01-08 |