| NPI | 1508882994 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0101242316) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 239720) |
| Enumeration Date | 2006-07-15 |
| Last Update Date | 2022-02-28 |