| NPI | 1306253844 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA 85672) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 291119) |
| Enumeration Date | 2014-07-16 |
| Last Update Date | 2021-02-08 |