| NPI | 1326209792 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 257784) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VA 0102203638) |
| Enumeration Date | 2008-06-18 |
| Last Update Date | 2019-02-04 |