| NPI | 1073541546 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 238824) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MD D0061429) |
| Enumeration Date | 2006-06-30 |
| Last Update Date | 2023-07-05 |