| NPI | 1609820901 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 206099) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME77184) |
| 207P00000X Emergency Medicine (Licence: PA MD421003) | |
| Enumeration Date | 2006-05-20 |
| Last Update Date | 2022-04-13 |