| NPI | 1740265792 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 228260) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL me82158) |
| 207P00000X Emergency Medicine (Licence: CA a81145) | |
| 207P00000X Emergency Medicine (Licence: HI md-12159) | |
| Enumeration Date | 2005-12-13 |
| Last Update Date | 2016-07-21 |