| NPI | 1649598871 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 270455) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NH 18289) |
| Enumeration Date | 2010-05-12 |
| Last Update Date | 2017-12-11 |