| NPI | 1548229792 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 177981-1) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VA 0101255055) |
| 207P00000X Emergency Medicine (Licence: NC 2012-02014) | |
| 207P00000X Emergency Medicine (Licence: NJ 25MA05206400) | |
| 207P00000X Emergency Medicine (Licence: RI MD13999) | |
| Enumeration Date | 2006-03-17 |
| Last Update Date | 2015-06-08 |