| NPI | 1003220864 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 288929) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MT206727) |
| Enumeration Date | 2014-06-19 |
| Last Update Date | 2017-07-24 |