| NPI | 1235242777 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA OS006315L) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 246087) |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2021-02-26 |