| NPI | 1275749087 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 281265) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA OT011544) |
| Enumeration Date | 2007-05-16 |
| Last Update Date | 2021-07-09 |