| NPI | 1053409854 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NC 2007-00465) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 235428) |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2018-08-01 |