| NPI | 1992880322 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL 142489) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 235909) |
| Enumeration Date | 2006-10-26 |
| Last Update Date | 2021-03-16 |