| NPI | 1225094220 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 229188) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 053473) |
| Enumeration Date | 2006-04-26 |
| Last Update Date | 2021-03-29 |