| NPI | 1407176233 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 269998-1) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CT 54806) |
| Enumeration Date | 2010-06-03 |
| Last Update Date | 2022-05-02 |