| NPI | 1215296207 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 294408-1) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MD D79035) |
| Enumeration Date | 2012-05-10 |
| Last Update Date | 2018-09-19 |