| NPI | 1609899467 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME97276) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 206879) |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2009-11-16 |