| NPI | 1477915882 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 305292) |
| Additional Taxonomies | 282N00000X General Acute Care Hospital (Licence: NY 456269350) |
| Enumeration Date | 2016-03-24 |
| Last Update Date | 2020-11-04 |