| NPI | 1629118203 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SC 34131) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 235871) |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2020-12-01 |