| NPI | 1063943272 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 314733) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: SC 85561) |
| Enumeration Date | 2017-03-21 |
| Last Update Date | 2023-04-12 |