| NPI | 1396035788 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: LA MD.206851) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: LA 206851) |
| 207P00000X Emergency Medicine (Licence: NY 283449) | |
| Enumeration Date | 2011-04-19 |
| Last Update Date | 2021-11-15 |