| NPI | 1255642369 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA 172059) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 269931) |
| Enumeration Date | 2010-06-24 |
| Last Update Date | 2021-12-20 |