| NPI | 1548467566 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CT 056669) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 268681-1) |
| Enumeration Date | 2007-07-02 |
| Last Update Date | 2019-02-25 |