| NPI | 1962548636 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 273925) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MT184045) |
| 207P00000X Emergency Medicine (Licence: DE C1-0008382) | |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2014-10-08 |