| NPI | 1508090150 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 271580-01) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PR 29010) |
| Enumeration Date | 2009-05-12 |
| Last Update Date | 2023-11-30 |