| NPI | 1629393574 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NC 201500660) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 256629) |
| Enumeration Date | 2010-04-05 |
| Last Update Date | 2021-12-23 |