| NPI | 1114347416 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 283519) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MA 269719) |
| Enumeration Date | 2014-04-24 |
| Last Update Date | 2019-09-03 |