| NPI | 1235524265 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 291943-1) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CT 57268) |
| Enumeration Date | 2015-04-06 |
| Last Update Date | 2018-04-09 |