| NPI | 1780859652 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MS 22438) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 262465) |
| 207P00000X Emergency Medicine (Licence: FL ME122355) | |
| Enumeration Date | 2008-04-23 |
| Last Update Date | 2022-07-21 |