| NPI | 1265798615 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 272096-1) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 272096) |
| Enumeration Date | 2012-04-10 |
| Last Update Date | 2023-06-30 |