| NPI | 1285126425 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 311730) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 010018) |
| Enumeration Date | 2018-06-04 |
| Last Update Date | 2021-12-01 |