| NPI | 1144504440 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CT 52626) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 275616) |
| Enumeration Date | 2011-10-05 |
| Last Update Date | 2024-06-20 |