| NPI | 1245261551 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CT 42440) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 234179-1) |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2022-07-21 |