| NPI | 1083146047 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 310739) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CT 64901) |
| Enumeration Date | 2017-03-29 |
| Last Update Date | 2021-08-18 |