| NPI | 1578509618 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 218602) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CT 73747) |
| Enumeration Date | 2006-06-20 |
| Last Update Date | 2023-10-09 |