| NPI | 1972589893 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL OS10944) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 250919) |
| Enumeration Date | 2005-12-22 |
| Last Update Date | 2016-01-27 |