| NPI | 1134356652 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NC 2018-00595) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 265460) |
| Enumeration Date | 2009-06-11 |
| Last Update Date | 2022-10-12 |