| NPI | 1770510893 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 223773) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME89594) |
| Enumeration Date | 2006-06-26 |
| Last Update Date | 2010-08-30 |