| NPI | 1609036094 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 261263) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GU EMTL-2022-008) |
| Enumeration Date | 2008-06-10 |
| Last Update Date | 2022-03-29 |