| NPI | 1053419911 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 195289) |
| Additional Taxonomies | 208600000X Surgery (Licence: NY 195289) |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2021-09-20 |