| NPI | 1629231329 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: ME DO2354) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 261554) |
| Enumeration Date | 2008-07-03 |
| Last Update Date | 2019-01-18 |