| NPI | 1144588567 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 285902) |
| Additional Taxonomies | 208600000X Surgery (Licence: CT AS2383278-0813) |
| Enumeration Date | 2012-04-24 |
| Last Update Date | 2018-03-17 |