| NPI | 1114217726 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 278657) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NM RS2011-0322) |
| Enumeration Date | 2011-04-15 |
| Last Update Date | 2023-05-15 |