| NPI | 1588890560 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: MA 282337) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MA 282337) |
| 207P00000X Emergency Medicine (Licence: NY 275155) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: NY 275155) | |
| Enumeration Date | 2009-06-04 |
| Last Update Date | 2020-04-21 |