| NPI | 1487048815 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OR MD186528) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NY 63666) |
| 207P00000X Emergency Medicine (Licence: NY 286978-1) | |
| Enumeration Date | 2015-03-24 |
| Last Update Date | 2018-07-25 |