| NPI | 1659304913 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 213528) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: LA 15221R) |
| Enumeration Date | 2006-07-09 |
| Last Update Date | 2014-07-10 |