| NPI | 1215183751 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NH T0638) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 260578) |
| Enumeration Date | 2008-08-15 |
| Last Update Date | 2017-01-11 |