| NPI | 1417105404 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 252869) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL 156694) |
| Enumeration Date | 2008-09-03 |
| Last Update Date | 2022-11-28 |