| NPI | 1477674521 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 235968) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MA 231118) |
| Enumeration Date | 2007-04-03 |
| Last Update Date | 2019-10-03 |